Photo By Jon Hughes/photopresse.com

Once homeless, Anita Idler now volunteers for Welcome House.

When you can't get out of bed, it's hard to make it to work. When you can't stop the voices within, it's hard concentrate on paying rent. When you steal from your family to self-medicate with street drugs, sometimes they put you out. When you can't get to sleep in the woods, sometimes you drink.

The connection between mental illness and homelessness is undeniable. The National Coalition for the Homeless estimates that 20-25 percent of the single adult homeless population suffers from some form of severe and persistent mental illness.

Throw in substance abuse and it's not as easy as "Get a job, get an apartment, get a life."

Sometimes bootstraps by which you'd pull yourself up have been frayed to the breaking point.

'These people are worthwhile'
Rachael Winters estimates that 50-70 percent of the homeless people she sees suffer from mental illness. She is homeless services project coordinator for Welcome House of Northern Kentucky, which works mostly with homeless men.

Last year 211 clients participated in the Covington-based program, which helps them obtain mental health treatment, substance abuse recovery, employment assistance, life skills and peer support.

Northern Kentucky has no long-term shelter for men. "There's no transitional step" to move them from homelessness to housing, Winters says.

"You can get seven days at the shelter and after that you're back down again," she says.

The most important thing to understand is the time required for change, according to Winters.

"The process by which somebody moves from homelessness to having stability does not take a day," she says. "Lack of sleep is the number one reason people don't feel well enough to try. How are they supposed to try to do things differently?"

For years she's served coffee in Goebel Park every Sunday. It took her four years to gain one man's trust. At first he wouldn't talk. He slept in the woods by State Route 8 and drank himself to sleep every night.

After three years, he made it through the Welcome House door. Winters discovered he was a Vietnam vet who had gotten hooked on intravenous drugs while in the service. She helped him apply for veterans' benefits that she then used to help him move into a nice, quiet apartment. That was 12 days ago, and since then she says he's only drunk twice.

Winters' homeless clients have told her they didn't seek or accept offers of help because they don't believe anything will change. When people don't seem to want help, Winters doesn't give up.

"We have to keep trying," she says. "We have to consider that these people are worthwhile to try."

William, a Welcome House client, knows something about trying.

"When you don't have a place, it's really hard, and you remember that when you do get a place, because you feel so much more fortunate," William says.

He allows his real first name to be used "if this is gonna help people."

William now has a place and has been sober almost two years, but it's still not easy.

"I wanted to get drunk so bad Sunday night," he says. "I just took my medication, sat in my house and stared at the walls."

His two children, 16 and 17, can call him now that he has a phone.

"My kids have been in focus more since I've been sober," he says. "My daughter puts me in check all the time."

Reuniting with alienated family members is very important to most of the people Winters works with, but it's also frightening, she says.

"(They) must think about, 'What did I do in the past? Can I make it up? Are they going to accept me as I am now?' " Winters says.

'Locked me up and let me go'
Anita Idler asks that her full name be used, hoping it will help her reunite with her sister, from whom she once stole their deceased sister's necklace to sell for crack.

She says she's been homeless the majority of her life. Her mother gave Idler her first drink and her first joint, she says. When her mother drowned, Idler jumped in the water but couldn't save her.

When Idler was 12 years old, five men raped her. She's been jailed more than 35 times, mostly for prostitution, she says. She's been beaten often and once tied up and left for dead.

"I just wanted to stay high because I didn't want to confront my feelings," she says.

Idler has now been through six rehabs. This is her third time working with Welcome House. She's been sober for seven months, with the help of the AA meetings she attends seven days a week. She volunteers every day at Welcome House, cleaning the day room and greeting people. She's also getting ready to move into a new apartment.

"These are the dreams I've been trying to get for 12 years," she says. "Rachael made my dreams come true."

"No," Winters corrects her. "You made your dreams come true."

A Human Rights Watch study in September reported between 200,000 and 300,000 people in U.S. prisons suffer from mental disorders, including schizophrenia, bipolar disorder and major depression.

"Without the necessary care, mentally ill prisoners suffer painful symptoms and their conditions can deteriorate," the report says.

The study estimates that 70,000 prisoners are psychotic on any given day.

"Prisons were never intended as facilities for the mentally ill, yet that is one of their primary roles today," the study says. "Many of the men and women who cannot get mental health treatment in the community are swept into the criminal justice system after they commit a crime."

That's what happened to Welcome House client Jim Palmer, who says he spent nine years in prison for $35 worth of crack. The man who shot his brother point-blank in the back got only four and a half years for homicide, he says.

While serving time, Palmer worked hard to educate himself, getting a GED, an associate degree and technical training in cabinetmaking and design. But when he was released, he didn't know how to apply his education. Prison hadn't provided the court-ordered drug treatment, much less job assistance.

"Nobody really paid attention to anything other than my release date," he says. "They just locked me up and let me go."

In prison, Palmer had adjusted to being confined and having everything provided to him. After release, he was scared to death.

"I hate to admit that, but I was scared," he says. "I didn't know what to do. Naturally, I went back to doing what I did best -- running the streets, doing drugs."

He lived in drug houses and any place he could set up shop and hang out. Later he came to loathe staying indoors. He lived outside and stayed awake for "weeks at a time."

"I'd been locked up so long I didn't want to be nowhere nobody closed the door on me," he says. "I didn't feel comfortable about being around people, not unless I was high."

Palmer started going to Welcome House to hang out in the day room.

"I came here when I felt so bad I needed to talk to somebody," he says.

He kicked drugs twice but fell back to them. He was addicted to painkillers, used cocaine to work through withdrawal symptoms and got hooked on that.

"Something else was wrong and I couldn't figure out what it was," he says.

In addition to his addiction, he suffered depression and severe mood swings.

"I got a real bad attitude," he says.

Palmer says he was banned from nearly every store in the Tristate, where pictures of him hung behind counters "like I'd robbed the bank or something."

He says he was introduced to heroin at age 14 and finally emerged from his "drug-induced coma" at about 45 years old.

Palmer's been sober four months this time but made it 16 months once before. More than anything he wanted his own place, where he didn't have to worry about being put out.

"I stayed homeless because I couldn't learn to say, 'Could you help me please?' " he says.

Now he has an apartment in a nice part of Covington. He takes medication for depression and blood pressure and relies on a support network 15 people deep. He also mans the Alcoholics Anonymous crisis line.

"I never thought that I would be the one helping anybody do anything other than destroy themselves," he says.

To die on clean sheets
The growth in homelessness can't be directly attributed to the 1950s and 1960s release of seriously mentally ill people from institutions, according to the National Coalition for the Homeless.

"Vast increases in homelessness did not occur until the 1980s, when incomes and housing options for those living on the margins began to diminish rapidly," the organization's literature says. However, a new wave of deinstitutionalization might have aggravated the problem, according to the organization.

Five local psychiatric facilities have closed, including Rollman Psychiatric Institute, according to "Hospital Data and Trends," a report by Lynn Olman for the Greater Cincinnati Foundation.

Nineteen years ago the Rev. Chris Hall met two women recently released from Rollman with nothing but cab fare to the Drop-Inn Center. He helped them find housing and services. But within two months one was murdered and the other raped, both in their own apartments.

Hall recognized a need for permanent housing and individualized services for the chronically mentally ill. Along with two other clergymen, he founded Tender Mercies.

The agency now owns and operates seven buildings, each less than a block from Washington Park in Over-the-Rhine. Six of the buildings provide permanent housing for 150 residents; the seventh functions as transitional housing.

The buildings feature the rare "single-room occupancy" (SRO) housing of the Over-the-Rhine hotels that, in their heyday, served traveling salespeople taking wares to Court Street.

Tender Mercies strives to preserve residents' autonomy. They come and go as they please, though there are restrictions on guest visits.

"With the rise of the psychotropic drug therapies which a couple of decades ago we didn't have, the vision was that people would be able to leave the back wards of the state institution and live out in the communities," says Edward Slater, community resource director and one of the three founders.

For a lot of people that happened, but others slipped between the fingers of a community ill-prepared to receive them. Tender Mercies has made a difference.

"Any number of folks have died in their own room on clean sheets and much mourned by the folks who knew them," Slater says.

Each furnished room at Tender Mercies has a small chest refrigerator, but housing ordinances prohibit cooking in SROs, so the organization also offers an extensive meal program. One hundred fifteen groups volunteer to provide residents meals. Slater organizes the monthly meal volunteer schedule.

"I'm like a maitre d' in reverse," he says. "I've got the people, you've got the food."

The meal program tries to provide residents with at least one meal a day, and someone's always available to help them strategize resources to prepare their own. It's a delicate approach.

"We want to provide support but not make people dependent on the program," Slater says.

All buildings have a common space, kitchen and laundry facilities. Two have 24-hour staff presence and a locked cabinet where residents can keep their medication.

Staff doesn't dispense medication but assists in its management. If someone chooses to stop meds, the staff makes note of it. Tender Mercies takes residents to a hospital when necessary. When they return?

"We're here for that, too," Slater says.

Photo By Jon Hughes/photopresse.com

Sober for the past seven months, Idler greets a visitor at Welcome House with a toast: "Pepsi, not beer!"

The process of getting on Social Security can take up to two years, especially if identification must be established, he says.

'Our own little oasis'
As far as Slater knows, Tender Mercies is one of only four such permanent housing organizations for the mentally ill in the United States.

"There's a long-haul dimension to it, because we don't have a cure for some of these illnesses," he says.

Add to that issues around low-income housing, and the prospect of such an organization becomes daunting. Or maybe more such organizations don't exist because of neighbors' discomfort.

"It's great what you do, but could you do it someplace else?" Slater paraphrases.

Tender Mercies limits its capacity to 150 residents in order to present a viable model and to get "deeper" rather than bigger -- Slater wants to know everyone's name and preserve a sense of community.

Sue has lived at Tender Mercies for 10 years. She's coordinated the commissary for four years, training other residents to work there.

"We're friendly and try not to even shortchange," she says. "We give the change back correctly. We're very customer friendly because they're not next door."

The commissary, which sells everything at cost, is an alternative to local stores' "draconian credit practices and prices," Slater says. A pack of Brave cigarettes costs $1.50.

Tender Mercies enjoys a constructive relationship with police; in fact, it has helped train Cincinnati Police officers on mental health issues.

"We want to be a good neighbor," Slater says. "We're part of the solution."

Mental illness is "an illness that's difficult to understand because you can't see it," says Marcia Spaeth, chief executive officer of Tender Mercies. She shows off the new patio, big enough for six picnic tables, an enormous grill and what Slater calls "two of the most lazy, pampered cats in the city."

"It's our own little oasis, all done by volunteers," Spaeth says.

A reinforced section of the fence divides the patio from the streets where drug dealers often do business. Once a police officer chasing a dealer crashed right through the fence and crushed resident Donnell's tomato plants, about which Donnell (a pseudonym) was not pleased, Spaeth says.

She says Donnell goes to Washington Park every morning at 7:30 to drink from the fountain because it's holy. Slater, an ex-priest, has offered to get Donnell holy water, but he isn't having it. On a recent morning excursion he was jumped and badly beaten.

"Tender Mercies is good," a woman stops to tell Spaeth. "You just need to get some of the bad people out of here."

The agency's clients want what everybody in the neighborhood wants, according to Slater.

"They want it to be a safe, secure place," he says.

Years ago Slater sat with a group of women who were smoking and watching TV on a beautiful spring day.

"It's a lovely day, why don't you go to the park?" he said.

A woman took a long drag of her cigarette and said, "Aw, honey, I used to live in that park. It's much better here."

Slater laughs at the memory.

"She died peacefully in her own bed," he says. ©